Pay for testing supplies for Type 1 diabetes, panel says

Last Updated: Thursday, November 16, 2006 | 8:21 PM ET

CBC News

A panel of health experts, doctors and ethicists says it wants nationwide coverage of testing supplies for people on insulin with Type 1 diabetes.

"There should be full coverage, on the same basis as medically necessary drugs, for the insulin-dependent population," said Michael Decter, who chaired the panel at the Institute of Health Economics conference in Edmonton.   

Currently, places such as the Northwest Territories fully cover testing strips, while Alberta and Ontario cover part of the cost or pay for them in some circumstances. New Brunswick doesn't pay for the strips at all. Private insurance also picks up the tab.

The cost of the daily test strips adds up to $365 per person a year, or more than $700 million for the two million people with diabetes in Canada, Dr. Jeff Johnson, a researcher at the University of Alberta who has looked at the costs and benefits of the strips, said Thursday.

The test strips are a useful educational tool for people recently diagnosed with diabetes, helping them to match how they feel with their blood sugar levels.

The question of how often people with diabetes should test their blood sugar remained unanswered by the expert panel.

Frequent testing is valuable for people with Type 1 who may take insulin many times a day. But for people with Type 2, who aren't on insulin, the benefits are less clear and contentious.

Tests 'a jolt of reality'

Peter McDougall, who has Type 2 diabetes, came from New Brunswick to address the panel, urging them to cover the costs.

McDougall, whose supply costs won't be covered under the recommendation, said he worries about diabetes complications, which include blindness, losing a limb or needing kidney dialysis.

"Daily testing, or more-than-once-daily testing is a jolt of reality," McDougall said. "Every time I see the test results, I'm reminded that I have an incurable disease."

If people with diabetes who do not take insulin are doing the tests, but aren't acting on the information by making behavioural changes, then they probably are not getting much benefit, Decter said.

But the recommendation could lead to a two-tier system, with some diabetics paying  for their own test strips, said George Cembrowski, director of medical biology at the University of Alberta.

"If they have to pay for the strips, it seems that maybe the individuals who have dollars will have it and the lower-income individuals may not get it," Cembrowski, who also consults for test-strip manufacturers. "I think there should be equal access."

Cembrowski suggested that governments bargain with manufacturers to reduce the costs of the strips.

The full report will be sent to provinces, territories and health authorities.